9.30 robin ireland taking action tackling obesity ireland

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March 2014Health Equalities Group

TAKING ACTION: TACKLING OBESITY AND RELATED CONDITIONS

Robin IrelandChief Executive, Health Equalities Group

Tackling obesity and related conditions

Health Equalities Group

In my home city of Liverpool:

13.3% of children aged 4-5 years and 23.2% of children aged 10-11 years are classified as obese.

This contributes to a life expectancy at birth of three years below the England average.

In addition 33% of children aged under 16 years are living in poverty

Source: PHE, Child Health Profiles, March 2014



How are we measuring up to the medical profession’s prescription for the nation’s obesity crisis? (Academy of Medical Royal Colleges, 2013)

“Health policy can be slow to emerge even when evidence is strong. The lobbying opposition to intervention can be well-rehearsed when commercial interests are at stake” p.15



An Effectiveness Hierarchy for Public Health

‘Downstream’ prevention interventions targeting individuals consistently achieve a smaller public health impact than ‘Upstream’ population based policies such as regulation or taxes…Capewell, 2014



Upstream – Downstream: ‘The Ambulance Down in the Valley’

The Safety Net – represents secondary prevention for people who are already sick.

The Ambulance – represents acute medical care for people who are sick.

Moving people away from the cliff edge – represents addressing the social determinants of health

The Fence – represents primary prevention with a focus on individual risk.

Based on poem by Joseph Malins ‘The Ambulance Down in the Valley’ (1895). Original Diagram at: “Addressing the Social Determinants of Children’s Health: A Cliff Analogy”, http://www.vdh.virginia.gov/healthpolicy/healthequity/documents/cliff-analogy.pdf



Nuffield ladder of public health interventions•Eliminate choice e.g. isolate patient with nasty infectious

disease

•Restrict choice e.g. remove toxins from drinking water

•Guide choice

•Through disincentives e.g. tobacco tax, congestion

charging

•Through incentives e.g. tax breaks for cycling to work

•Changing default e.g. side dish routinely salad, chips

optional

•Enable choice e.g. provide free fruit at schools, free

gyms etc

•Provide information e.g. campaigns on walking or

eating fruit

•Do nothing or simply monitor the situation



So why the focus on

individual (i.e.

downstream) measures?



So if we know what might work, let’s

consider how five of the Academy’s

ten recommendations are

progressing. Most have been in the

media recently.

None are magic bullets but together,

they could have impact…



3. Food-based standards in line with those put in place for schools in England in 2006 should be introduced in all UK hospitals in the next 18 months.“It’s time for compulsory hospital food standards.” Campaign for Better Hospital Food www.sustainweb.org/hospitalfood/



7. A ban on advertising of foods high in saturated fats, sugar and salt before 9pm, and an agreement from commercial broadcasters that they will not allow these foods to be advertised on internet ‘on-demand’ services.Action on Junk Food Marketing launched in March 2014. Sign a petition calling on the Government to block junk food marketing to children: www.bhf.org.uk/ditchthejunk



8. For an initial one year, a duty should be piloted on all sugary soft drinks, increasing the price by at least 20%.

New research reinforces calls for a tax on sugary drinks: www.foodactive.org.uk



9. Major food manufacturers and supermarkets should agree by the end of 2013 a unified system of traffic light food labelling …and visible calorie indicators for restaurants, especially fast food outlets.A voluntary front of pack nutrition-based traffic light labelling scheme will be introduced in England in December 2014.



10. …Local authorities (should) encourage active travel and protect or increase green spaces to make the healthy option the easy option.



Learning from Tobacco Control

•Affordability- Increased duties on sugary drinks

•Acceptability- Ban junk food marketing on TV

before 9pm

•Accessibility- Support local authorities to

develop planning regulations to reduce the

number of fast food outlets



Commercial Determinants of Health Glo-Local Masterclass- Thursday 9th May 2014, 12pm-4.30pm, City Tower, Piccadilly Plaza, ManchesterGet more info or book your place by emailing: [email protected] or tweeting @food_active

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DateHealth Equalities Group

THANKYOU

Robin IrelandChief [email protected]@robinHEG0151 237 2686

Health & Medicine

9.30 robin ireland taking action tackling obesity ireland